Individual Treatment of Posttraumatic Stress Disorder Using Mantram Repetition: A Randomized Clinical Trial
Objective:Previous studies suggest that group “mantram” (sacred word) repetition therapy, a non-trauma-focused complementary therapy for posttraumatic stress disorder (PTSD), may be an effective treatment for veterans. The authors compared individually delivered mantram repetition therapy and anothe...
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Veröffentlicht in: | The American journal of psychiatry 2018-10, Vol.175 (10), p.979-988 |
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creator | Bormann, Jill E Thorp, Steven R Smith, Eric Glickman, Mark Beck, Danielle Plumb, Dorothy Zhao, Shibei Ackland, Princess E Rodgers, Carie S Heppner, Pia Herz, Lawrence R Elwy, A. Rani |
description | Objective:Previous studies suggest that group “mantram” (sacred word) repetition therapy, a non-trauma-focused complementary therapy for posttraumatic stress disorder (PTSD), may be an effective treatment for veterans. The authors compared individually delivered mantram repetition therapy and another non-trauma-focused treatment for PTSD.Method:The study was a two-site, open-allocation, blinded-assessment randomized trial involving 173 veterans diagnosed with military-related PTSD from two Veterans Affairs outpatient clinics (January 2012 to March 2014). The mantram group (N=89) learned skills for silent mantram repetition, slowing thoughts, and one-pointed attention. The comparison group (N=84) received present-centered therapy, focusing on currently stressful events and problem-solving skills. Both treatments were delivered individually in eight weekly 1-hour sessions. The primary outcome measure was change in PTSD symptom severity, as measured by the Clinician-Administered PTSD Scale (CAPS) and by self-report. Secondary outcome measures included insomnia, depression, anger, spiritual well-being, mindfulness, and quality of life. Intent-to-treat analysis was conducted using linear mixed models.Results:The mantram group had significantly greater improvements in CAPS score than the present-centered therapy group, both at the posttreatment assessment (between-group difference across time, −9.98, 95% CI=−3.63, −16.00; d=0.49) and at the 2-month follow-up (between-group difference, −9.34, 95% CI=−1.50, −17.18; d=0.46). Self-reported PTSD symptom severity was also lower in the mantram group compared with the present-centered therapy group at the posttreatment assessment, but there was no difference at the 2-month follow-up. Significantly more participants in the mantram group (59%) than in the present-centered therapy group (40%) who completed the 2-month follow-up no longer met criteria for PTSD (p |
doi_str_mv | 10.1176/appi.ajp.2018.17060611 |
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Rani</creator><creatorcontrib>Bormann, Jill E ; Thorp, Steven R ; Smith, Eric ; Glickman, Mark ; Beck, Danielle ; Plumb, Dorothy ; Zhao, Shibei ; Ackland, Princess E ; Rodgers, Carie S ; Heppner, Pia ; Herz, Lawrence R ; Elwy, A. Rani</creatorcontrib><description>Objective:Previous studies suggest that group “mantram” (sacred word) repetition therapy, a non-trauma-focused complementary therapy for posttraumatic stress disorder (PTSD), may be an effective treatment for veterans. The authors compared individually delivered mantram repetition therapy and another non-trauma-focused treatment for PTSD.Method:The study was a two-site, open-allocation, blinded-assessment randomized trial involving 173 veterans diagnosed with military-related PTSD from two Veterans Affairs outpatient clinics (January 2012 to March 2014). The mantram group (N=89) learned skills for silent mantram repetition, slowing thoughts, and one-pointed attention. The comparison group (N=84) received present-centered therapy, focusing on currently stressful events and problem-solving skills. Both treatments were delivered individually in eight weekly 1-hour sessions. The primary outcome measure was change in PTSD symptom severity, as measured by the Clinician-Administered PTSD Scale (CAPS) and by self-report. Secondary outcome measures included insomnia, depression, anger, spiritual well-being, mindfulness, and quality of life. Intent-to-treat analysis was conducted using linear mixed models.Results:The mantram group had significantly greater improvements in CAPS score than the present-centered therapy group, both at the posttreatment assessment (between-group difference across time, −9.98, 95% CI=−3.63, −16.00; d=0.49) and at the 2-month follow-up (between-group difference, −9.34, 95% CI=−1.50, −17.18; d=0.46). Self-reported PTSD symptom severity was also lower in the mantram group compared with the present-centered therapy group at the posttreatment assessment, but there was no difference at the 2-month follow-up. Significantly more participants in the mantram group (59%) than in the present-centered therapy group (40%) who completed the 2-month follow-up no longer met criteria for PTSD (p<0.04). However, the percentage of participants in the mantram group (75%) compared with participants in the present-centered therapy group (61%) who experienced clinically meaningful changes (≥10-point improvements) in CAPS score did not differ significantly between groups. Reductions in insomnia were significantly greater for participants in the mantram group at both posttreatment assessment and 2-month follow-up.Conclusions:In a sample of veterans with PTSD, individually delivered mantram repetition therapy was generally more effective than present-centered therapy for reducing PTSD symptom severity and insomnia.</description><identifier>ISSN: 0002-953X</identifier><identifier>EISSN: 1535-7228</identifier><identifier>DOI: 10.1176/appi.ajp.2018.17060611</identifier><identifier>PMID: 29921143</identifier><language>eng</language><publisher>United States: American Psychiatric Association</publisher><subject>Alternative medicine ; Clinical trials ; Female ; Humans ; Male ; Meditation ; Middle Aged ; Outcome Assessment (Health Care) ; Post traumatic stress disorder ; Precision medicine ; Psychotherapy ; Single-Blind Method ; Stress Disorders, Post-Traumatic - therapy ; Treatment Outcome ; Veterans ; Veterans health care ; Well being</subject><ispartof>The American journal of psychiatry, 2018-10, Vol.175 (10), p.979-988</ispartof><rights>Copyright © 2018 by the American Psychiatric Association 2018</rights><rights>Copyright American Psychiatric Association Oct 1, 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a464t-23d0bddd21243dee8b669039d1d8308c02e43bc9d23df060f936ccbdd75745b53</citedby><cites>FETCH-LOGICAL-a464t-23d0bddd21243dee8b669039d1d8308c02e43bc9d23df060f936ccbdd75745b53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/appi.ajp.2018.17060611$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/appi.ajp.2018.17060611$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>314,776,780,2842,21605,21606,21607,27901,27902,77537,77542</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29921143$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bormann, Jill E</creatorcontrib><creatorcontrib>Thorp, Steven R</creatorcontrib><creatorcontrib>Smith, Eric</creatorcontrib><creatorcontrib>Glickman, Mark</creatorcontrib><creatorcontrib>Beck, Danielle</creatorcontrib><creatorcontrib>Plumb, Dorothy</creatorcontrib><creatorcontrib>Zhao, Shibei</creatorcontrib><creatorcontrib>Ackland, Princess E</creatorcontrib><creatorcontrib>Rodgers, Carie S</creatorcontrib><creatorcontrib>Heppner, Pia</creatorcontrib><creatorcontrib>Herz, Lawrence R</creatorcontrib><creatorcontrib>Elwy, A. Rani</creatorcontrib><title>Individual Treatment of Posttraumatic Stress Disorder Using Mantram Repetition: A Randomized Clinical Trial</title><title>The American journal of psychiatry</title><addtitle>Am J Psychiatry</addtitle><description>Objective:Previous studies suggest that group “mantram” (sacred word) repetition therapy, a non-trauma-focused complementary therapy for posttraumatic stress disorder (PTSD), may be an effective treatment for veterans. The authors compared individually delivered mantram repetition therapy and another non-trauma-focused treatment for PTSD.Method:The study was a two-site, open-allocation, blinded-assessment randomized trial involving 173 veterans diagnosed with military-related PTSD from two Veterans Affairs outpatient clinics (January 2012 to March 2014). The mantram group (N=89) learned skills for silent mantram repetition, slowing thoughts, and one-pointed attention. The comparison group (N=84) received present-centered therapy, focusing on currently stressful events and problem-solving skills. Both treatments were delivered individually in eight weekly 1-hour sessions. The primary outcome measure was change in PTSD symptom severity, as measured by the Clinician-Administered PTSD Scale (CAPS) and by self-report. Secondary outcome measures included insomnia, depression, anger, spiritual well-being, mindfulness, and quality of life. Intent-to-treat analysis was conducted using linear mixed models.Results:The mantram group had significantly greater improvements in CAPS score than the present-centered therapy group, both at the posttreatment assessment (between-group difference across time, −9.98, 95% CI=−3.63, −16.00; d=0.49) and at the 2-month follow-up (between-group difference, −9.34, 95% CI=−1.50, −17.18; d=0.46). Self-reported PTSD symptom severity was also lower in the mantram group compared with the present-centered therapy group at the posttreatment assessment, but there was no difference at the 2-month follow-up. Significantly more participants in the mantram group (59%) than in the present-centered therapy group (40%) who completed the 2-month follow-up no longer met criteria for PTSD (p<0.04). However, the percentage of participants in the mantram group (75%) compared with participants in the present-centered therapy group (61%) who experienced clinically meaningful changes (≥10-point improvements) in CAPS score did not differ significantly between groups. Reductions in insomnia were significantly greater for participants in the mantram group at both posttreatment assessment and 2-month follow-up.Conclusions:In a sample of veterans with PTSD, individually delivered mantram repetition therapy was generally more effective than present-centered therapy for reducing PTSD symptom severity and insomnia.</description><subject>Alternative medicine</subject><subject>Clinical trials</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Meditation</subject><subject>Middle Aged</subject><subject>Outcome Assessment (Health Care)</subject><subject>Post traumatic stress disorder</subject><subject>Precision medicine</subject><subject>Psychotherapy</subject><subject>Single-Blind Method</subject><subject>Stress Disorders, Post-Traumatic - therapy</subject><subject>Treatment Outcome</subject><subject>Veterans</subject><subject>Veterans health care</subject><subject>Well being</subject><issn>0002-953X</issn><issn>1535-7228</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1PwyAch4nR6Jx-BUPixUsnLy1tvZn5tmRGo1vijdBCDbOFCtREP73MqQcvXiAkz-_3Bx4AjjCaYJyzU9H3eiJW_YQgXExwjhhiGG-BEc5oluSEFNtghBAiSZnRpz2w7_0qHhHNyS7YI2VJME7pCLzMjNRvWg6ihQunROiUCdA28N76EJwYOhF0DR-DU97DC-2tk8rBpdfmGd4KE5EOPqheBR20NWfwHD4II22nP5SE01YbXX9Va9EegJ1GtF4dfu9jsLy6XExvkvnd9Wx6Pk9EytKQECpRJaUkmKRUKlVUjJWIlhLLgqKiRkSltKpLGcEmvrspKavrmMizPM2qjI7Byaa3d_Z1UD7wTvtata0wyg6eExTBNCUFi-jxH3RlB2fi7Xgcn1Ec1zXFNlTtrPdONbx3uhPunWPE1zr4WgePOvhaB__REYNH3_VD1Sn5G_v5_wjQDfBV8Dv7n9pPFheYvw</recordid><startdate>20181001</startdate><enddate>20181001</enddate><creator>Bormann, Jill E</creator><creator>Thorp, Steven R</creator><creator>Smith, Eric</creator><creator>Glickman, Mark</creator><creator>Beck, Danielle</creator><creator>Plumb, Dorothy</creator><creator>Zhao, Shibei</creator><creator>Ackland, Princess E</creator><creator>Rodgers, Carie S</creator><creator>Heppner, Pia</creator><creator>Herz, Lawrence R</creator><creator>Elwy, A. Rani</creator><general>American Psychiatric Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20181001</creationdate><title>Individual Treatment of Posttraumatic Stress Disorder Using Mantram Repetition: A Randomized Clinical Trial</title><author>Bormann, Jill E ; Thorp, Steven R ; Smith, Eric ; Glickman, Mark ; Beck, Danielle ; Plumb, Dorothy ; Zhao, Shibei ; Ackland, Princess E ; Rodgers, Carie S ; Heppner, Pia ; Herz, Lawrence R ; Elwy, A. Rani</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a464t-23d0bddd21243dee8b669039d1d8308c02e43bc9d23df060f936ccbdd75745b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Alternative medicine</topic><topic>Clinical trials</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Meditation</topic><topic>Middle Aged</topic><topic>Outcome Assessment (Health Care)</topic><topic>Post traumatic stress disorder</topic><topic>Precision medicine</topic><topic>Psychotherapy</topic><topic>Single-Blind Method</topic><topic>Stress Disorders, Post-Traumatic - therapy</topic><topic>Treatment Outcome</topic><topic>Veterans</topic><topic>Veterans health care</topic><topic>Well being</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bormann, Jill E</creatorcontrib><creatorcontrib>Thorp, Steven R</creatorcontrib><creatorcontrib>Smith, Eric</creatorcontrib><creatorcontrib>Glickman, Mark</creatorcontrib><creatorcontrib>Beck, Danielle</creatorcontrib><creatorcontrib>Plumb, Dorothy</creatorcontrib><creatorcontrib>Zhao, Shibei</creatorcontrib><creatorcontrib>Ackland, Princess E</creatorcontrib><creatorcontrib>Rodgers, Carie S</creatorcontrib><creatorcontrib>Heppner, Pia</creatorcontrib><creatorcontrib>Herz, Lawrence R</creatorcontrib><creatorcontrib>Elwy, A. Rani</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bormann, Jill E</au><au>Thorp, Steven R</au><au>Smith, Eric</au><au>Glickman, Mark</au><au>Beck, Danielle</au><au>Plumb, Dorothy</au><au>Zhao, Shibei</au><au>Ackland, Princess E</au><au>Rodgers, Carie S</au><au>Heppner, Pia</au><au>Herz, Lawrence R</au><au>Elwy, A. Rani</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Individual Treatment of Posttraumatic Stress Disorder Using Mantram Repetition: A Randomized Clinical Trial</atitle><jtitle>The American journal of psychiatry</jtitle><addtitle>Am J Psychiatry</addtitle><date>2018-10-01</date><risdate>2018</risdate><volume>175</volume><issue>10</issue><spage>979</spage><epage>988</epage><pages>979-988</pages><issn>0002-953X</issn><eissn>1535-7228</eissn><abstract>Objective:Previous studies suggest that group “mantram” (sacred word) repetition therapy, a non-trauma-focused complementary therapy for posttraumatic stress disorder (PTSD), may be an effective treatment for veterans. The authors compared individually delivered mantram repetition therapy and another non-trauma-focused treatment for PTSD.Method:The study was a two-site, open-allocation, blinded-assessment randomized trial involving 173 veterans diagnosed with military-related PTSD from two Veterans Affairs outpatient clinics (January 2012 to March 2014). The mantram group (N=89) learned skills for silent mantram repetition, slowing thoughts, and one-pointed attention. The comparison group (N=84) received present-centered therapy, focusing on currently stressful events and problem-solving skills. Both treatments were delivered individually in eight weekly 1-hour sessions. The primary outcome measure was change in PTSD symptom severity, as measured by the Clinician-Administered PTSD Scale (CAPS) and by self-report. Secondary outcome measures included insomnia, depression, anger, spiritual well-being, mindfulness, and quality of life. Intent-to-treat analysis was conducted using linear mixed models.Results:The mantram group had significantly greater improvements in CAPS score than the present-centered therapy group, both at the posttreatment assessment (between-group difference across time, −9.98, 95% CI=−3.63, −16.00; d=0.49) and at the 2-month follow-up (between-group difference, −9.34, 95% CI=−1.50, −17.18; d=0.46). Self-reported PTSD symptom severity was also lower in the mantram group compared with the present-centered therapy group at the posttreatment assessment, but there was no difference at the 2-month follow-up. Significantly more participants in the mantram group (59%) than in the present-centered therapy group (40%) who completed the 2-month follow-up no longer met criteria for PTSD (p<0.04). However, the percentage of participants in the mantram group (75%) compared with participants in the present-centered therapy group (61%) who experienced clinically meaningful changes (≥10-point improvements) in CAPS score did not differ significantly between groups. Reductions in insomnia were significantly greater for participants in the mantram group at both posttreatment assessment and 2-month follow-up.Conclusions:In a sample of veterans with PTSD, individually delivered mantram repetition therapy was generally more effective than present-centered therapy for reducing PTSD symptom severity and insomnia.</abstract><cop>United States</cop><pub>American Psychiatric Association</pub><pmid>29921143</pmid><doi>10.1176/appi.ajp.2018.17060611</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Alternative medicine Clinical trials Female Humans Male Meditation Middle Aged Outcome Assessment (Health Care) Post traumatic stress disorder Precision medicine Psychotherapy Single-Blind Method Stress Disorders, Post-Traumatic - therapy Treatment Outcome Veterans Veterans health care Well being |
title | Individual Treatment of Posttraumatic Stress Disorder Using Mantram Repetition: A Randomized Clinical Trial |
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